A woman looks at the camera, rasping through a prominent hole in her throat. She takes the viewer through her morning routine: Putting in her teeth, putting on a wig, and placing a walnut sized hands-free device in her throat so that she can speak clearly. Then she ties a scarf around her neck to cover it, looking disconsolate.

Terrie Hall, a former smoker, lost her larynx due to oral and throat cancer, and died on Sept. 16, 2013. She is featured in a 2013 anti-smoking campaign by the Centers for Disease Control and Prevention (CDC). A 2013 study in the journal Lancet found that the campaign prompted roughly 100,000 smokers to quit after airing for just 12 weeks.

Recently, the CDC began broadcasting a new video campaign, called “Real Cost,” aimed at teens. Roughly 90 percent of all smokers begin smoking before they are 18, according to the CDC. The campaign is about “trying to reach those kids who are on the cusp of smoking,” according to Food and Drug Administration Commissioner Margaret Hamburg. The FDA works with the CDC to promote public health.

Like Terrie’s gruesome morning ritual, the “Real Cost” videos feature teens peeling off their skin and pulling out their teeth in order to pay what is said to be the real cost of smoking cigarettes.

These campaigns may sound convincing, albeit extreme. But do they work on teens?

A Legend survey conducted on March 31 using SurveyMonkey found that 50 percent of the 100 students responding believe that graphic images are effective in persuading teens not to smoke.

Jenn Epstein, Urban’s freshman health teacher and co-leader of the Health Initiative for Peer Education, thinks that despite the fact that anti-smoking campaigns can be effective for younger students, the “cool” factor that cigarettes have still prompts older students to start smoking.

A 2013 HIPE survey shows that the number of students who try smoking progressively increases from freshman to senior year. Although the majority of Urban students don’t ever try smoking, those who do often want to feel grown-up, rebellious, and cool, Epstein said.

A male Urban smoker, 17, with a self-proclaimed smoking “habit” noted that he recognizes “how damaging it is to be a regular, long-term smoker” and that he is “aware of the repercussions of smoking.” “I’ve never seen an ad that made me want to stop altogether,” he said, though he admitted that but “they can definitely be a reality check.”

The next challenge for public health campaigns may be the electronic cigarette, or “e-cigs,” which are becoming increasingly popular among U.S. teens. The FDA recently released new rules that call for strict regulation of electronic cigarettes, which includes a ban on the sale of electronic cigarettes to minors. San Francisco city supervisors on March 18 passed an ordinance banning sales of e-cigs to minors (see related story, “Allure of e-cigs obscures possible health risks, experts say”).